‘The Good Nurse’ by Charles Graeber

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Charles Graeber tells the story of a nurse convicted of killing patients.

When one creates a mental checklist of the most prolific serial killers in history, the name Charles Cullen probably doesn’t spring to mind. But it should. In fact, it should be at the top of the list.

Cullen, the subject of Charles Graeber’s “The Good Nurse,” is thought to be responsible for the deaths of as many as 400 patients during his career as a nurse, which spanned 16 years and 10 health care facilities in New Jersey and Pennsylvania. His crimes are outlined in Graeber’s new book, an absorbing tale that’s simultaneously terrifying and barely credible. If it weren’t for the author’s extensive use of footnotes to back up the details of his account, the entire story would be utterly unbelievable.

The truly terrifying aspect of Cullen’s crimes is the complete ordinariness of the situations in which they took place. Chances are, any one of us has had the same experience as any of Cullen’s victims. In many cases, relatives would leave their parent/sibling/child/spouse’s bedside thinking they were on the road to recovery, only to get a call from the hospital the next day saying their loved one had suddenly taken a turn for the worse and passed away during the night.

Cullen’s utter lack of remorse — or even accountability — sends chills up the reader’s back. Graeber writes that Cullen spoke to the police for seven hours straight after his arrest. “It wasn’t a confession so much as a story about himself, and one that he liked to hear.” In his telling, “the patients ‘passed’ or ‘expired’ or sometimes ‘died’; he ‘intervened’ or was ‘compelled to intervene’ — but Charles did not ‘kill,’ and there was no ‘murder.’ ”

Cullen can’t recall the names of most of his victims and is only able to loosely estimate how many deaths he was responsible for. “He’d been spiking the bags at random sometimes, sending them out like grenades,” Graeber tells us early on. (He says 40; law enforcement agencies place the toll at perhaps 10 times that, according to Graeber.)

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If there’s one flaw in Graeber’s book, it’s that it makes little attempt to parse out the motivation that propelled Cullen, aside from surface-level explanations. A lingering sense of vengeance stemming from his mother’s death years prior may have played a role, or perhaps it was just sheer boredom. But this probably isn’t the fault of Graeber. Cullen never spoke publicly about the case aside from courtroom outbursts, and Graeber says he is the only journalist whom he’s granted an interview.

Cullen is by no means Graeber’s only villain. “The Good Nurse” is less a portrait of a serial killer than it is a dissection of the supporting cast who unwittingly played a hand in his killing spree. Administrators and hospital officials are also painted with a sinister pen, and Cullen’s career trajectory is reminiscent of the cover-up perpetrated by the Catholic Church. The pattern of Cullen leaving one job under a cloud of suspicion, personal issues, and/or disciplinary action and being able to find work at another facility almost immediately — even those that supposedly did background checks — is mind-boggling. And in an ironic twist, no one is more surprised by this than Cullen himself.

Though the conclusion is foregone (Cullen was arrested in 2003 and is serving several life sentences in a New Jersey prison), Graeber nonetheless manages to make “The Good Nurse” a suspenseful page-turner. His telling plays like an action movie or crime series, with deftly drawn characters and one memorable undercover witness, Cullen’s one-time “best friend” and co-worker, who was the linchpin for the police case that led to his arrest and conviction.

“The Good Nurse” is a standout true-crime book, one that doubles as both a thrilling horror story and a cautionary tale, and frightens and frustrates in equal measure.

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